Numerous factors increase the risk for GI complications in patients undergoing lung resection. It seems that the more debilitated the patient and the more extensive the COPD, the higher the risk. The most commonly reported cause of mortality after lung surgery is multi-organ failure accompanying respiratory failure. The trigger site for multi-system failure is often the GI system. Some risk factors cannot be altered, such as diabetes and the cardiovascular effects of long-term smoking. Other factors, such as steroid dose, anemia, hypoxia, narcotics, and other medications, can be modified. In addition, a high suspicion and early recognition of GI problems in the postoperative period can decrease their mortality. Severe GI complications after lung resection may be frustrating and poorly tolerated in high-risk patients, with little margin for error. Heightened awareness along with early recognition can prevent these complications and alter their outcome.